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SHALLOWFORD GROUP HOME NPI 1306981113


NPI Information

NPI: 1306981113
Provider Name: SHALLOWFORD GROUP HOME

Other Name: SHALLOWFORD GROUP HOME

Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization
Address:
2473 SHALLOWFORD RD NE
ATLANTA, GA
ZIP 30345
Phone: (404) 636-0955
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SHALLOWFORD GROUP HOME is a community behavioral health in Atlanta, GA. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. SHALLOWFORD GROUP HOME NPI is 1306981113. The provider is registered as an organization entity type.
The provider Other Name Is Shallowford Group Home.

The provider's business location address is:

2473 SHALLOWFORD RD NE
ATLANTA, GA
ZIP 30345-363
Phone: (404) 636-0955
Fax: (404) 636-0955

The provider's authorized official is Fabio Bruno Van Der Merwe .
The authorized official title is Coo and has the following contact phone number (404) 294-3836.

The enumeration date for this NPI number is 2/20/2007 and was last updated on 4/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1251S00000XCommunity/Behavioral HealthYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.